ECHO-COPD: Impact of a Pharmacist-Led Health Belief Model-Based Educational Intervention Among COPD Patients

The HBM will guide the content and delivery of the pharmacist-led educational intervention. The intervention will address the six core constructs of the HBM:

• Perceived susceptibility
• Perceived severity
• Perceived benefits
• Perceived barriers
• Cues to action
• Self-efficacy The purpose of applying the HBM is to influence patients' understanding of COPD and promote positive behavioural changes, particularly improvements in medication adherence. The study will then examine the relationship between these improvements and quality of life, healthcare utilisation, and direct healthcare costs.

The intervention will consist of structured face-to-face educational sessions conducted in the designated counselling room of the Pulmonary Department at BCH. Sessions will incorporate printed educational materials, lectures, counselling, practical demonstrations, motivational support, problem-solving strategies, and reinforcement of behavioural changes.

The educational programme will cover aspects of COPD management, medication adherence and appropriate medication use, COPD risk factors and complications, nutrition and preventive care, smoking cessation, barriers to recommended behaviours, cues to action, and strategies to improve patients' confidence in managing COPD.

Participants in the intervention and control groups will undergo pre-intervention assessments. Participants in the intervention group will subsequently receive the structured educational programme, while the control group will continue to receive standard care without additional educational input. Post-intervention assessments will use the same measurement instruments to allow within-group and between-group comparisons.

Inclusion criteria

Participants must:

• Be adults aged 18-65 years.
• Be diagnosed with COPD stages I-III according to GOLD guidelines.
• Have visited or been admitted for a COPD exacerbation and be receiving care at BCH in Al-Qassim Region, Saudi Arabia.
• Be Arabic-speaking and capable of understanding study instructions.
• Be willing and able to provide written informed consent.

Exclusion criteria

Participants will be excluded if they:

• Are diagnosed with COPD stage IV.
• Have another significant pulmonary disease, including:

• Asthma
• Bronchiectasis
• Pneumonia
• Cystic fibrosis
• Have a serious systemic illness, severe comorbidity, or central organ dysfunction, including:

• Hepatic dysfunction
• Renal dysfunction
• Psychiatric impairment
• Sensory impairment
• Are immunocompromised or receiving immunosuppressive treatment.
• Have psychological, sensory, or cognitive impairment that prevents meaningful participation in the study.